Even with a minimal risk, the possibility of a serious brain vessel rupture can weigh heavily on the mind, reveals a new study.
Research has shown that individuals with aneurysms (areas of weakness in brain blood vessels) are more likely to develop mental health issues compared to those without aneurysms. The risk is particularly high for patients under 40, as published today in Stroke, the peer-reviewed journal of the American Stroke Association, which is part of the American Heart Association.
An unruptured intracranial aneurysm happens when the blood vessel wall in the brain weakens and bulges, leading to a potential risk of rupture and severe bleeding in the brain.
“As a neurosurgeon treating cerebral aneurysms, I frequently encounter patients who don’t opt for surgery but experience fear and anxiety regarding their condition prior to imaging or monitoring tests. Even when it’s medically decided that observation is preferable to surgery, they remain concerned about the minimal risk of a life-threatening brain bleed,” said Na-Rae Yang, M.D., Ph.D., a co-author and assistant professor of neurosurgery at Ewha Womans University Mokdong Hospital, located at Ewha Womans University College of Medicine in Seoul, South Korea.
“This study did not specifically focus on brain aneurysms that were small enough to not require treatment and had a low rupture probability. We looked at all diagnosed but untreated brain aneurysms that were being monitored,” Yang explained. “A decision to avoid treatment may be due to the aneurysm being small and unlikely to rupture, indicating treatment may not be necessary. However, such decisions likely depend on various factors including the patient’s overall health, which were not detailed in our study group.”
While past studies have shown trends of stress and anxiety in patients diagnosed with aneurysms, the researchers noted that this is among the first large-scale studies assessing the risk of mental health disorders following an aneurysm diagnosis.
In their research, scientists analyzed data from the National Health Information Database in South Korea, which contains over two decades (2004 to 2024) of health records for more than 85,000 individuals visiting hospitals, clinics, and pharmacies nationwide. This database is one of the largest and most thorough health information sources globally. More than six months post-diagnosis of an aneurysm, researchers tracked how many individuals developed mental health disorders, such as anxiety, stress, depression, bipolar disorder, eating disorders, insomnia, and substance misuse. They compared these figures with those from similar adults without aneurysms who were treated for upper respiratory infections.
The analysis spanned a decade and revealed that compared to non-aneurysm individuals:
- Individuals with an aneurysm had a 10% higher likelihood of being diagnosed with a mental health condition;
- The risk of developing a mental health condition was especially significant in those with an aneurysm under the age of 40;
- In cases of mental health diagnoses made by a psychiatrist, the risk was even more pronounced, showing a threefold increase.
“Our findings highlight a greater incidence of serious mental health issues in younger adults with aneurysms, indicating a considerable psychological toll on this patient group who may already be juggling other life stressors, such as career-building or family-raising,” Yang stated. “The increased prevalence of mental health conditions suggests that younger individuals may be especially at risk, emphasizing the importance of targeted mental health support and interventions for this demographic, which includes clear communication and personalized treatment strategies,” Yang said.
An aneurysm may be identified when a person undergoes imaging (like a CT scan or MRI) to investigate neurological symptoms (such as headaches or changes in vision), or it may be discovered incidentally during imaging for unrelated reasons.
Limitations of the study include its reliance on diagnostic and prescription codes from a national database, which may not capture the full complexity of individual patient care and mental health conditions. Furthermore, the specific size and location of the aneurysms were not taken into account. This study denotes a potential correlation but does not validate a cause-and-effect relationship between an aneurysm diagnosis and subsequent mental health issues. Since the study population was based in South Korea, the results may not reflect trends in other countries.
Details and background of the study include:
- The research analyzed the rates of various mental health conditions over a 10-year span among 85,438 adults (51% male; average age of 56 years) diagnosed with untreated aneurysms between 2011 and 2019, compared to over 331,000 (49% male; average age of 57) without aneurysms who were treated for acute upper respiratory infections during the same timeframe. The non-aneurysm group was matched by age, sex, economic status, and existing health conditions.
- Mental health conditions were classified based on diagnoses of anxiety, stress, depressive disorders, bipolar disorder, eating disorders, insomnia, or alcohol and substance misuse according to the International Classification of Diseases codes. Those diagnosed with a mental health issue receiving treatment from a psychiatrist included therapies with or without medication.
- The analysis accounted for several factors, including age, sex, health insurance status, disabilities, other health conditions, smoking, alcohol use, and obesity, when calculating the differences in the risk of mental health conditions.
